Efficacy, pharmacokinetics and neurocognitive performance of dual, NRTI-sparing antiretroviral therapy in acute HIV-infection

Objectives Evaluate penetration of ARVs into compartments and efficacy of a dual, NRTI-sparing regimen in acute HIV infection (AHI). Design Single arm, open-label pilot study of participants with AHI initiating ritonavir-boosted darunavir 800 mg once daily plus etravirine 400 mg once daily or 200 mg twice daily within 30 days of AHI diagnosis. Methods Efficacy was defined as HIV RNA Results Fifteen AHI participants enrolled. Twelve (80%) participants achieved HIV RNA 2 tests below 1 SD), two had virologic failure. Conclusion NRTI-sparing ART started during AHI resulted in rapid viral suppression similar to NRTI-based regimens. More novel and compact two-drug treatments for AHI should be considered. Early institution of ART during AHI appears to improve overall neurocognitive function and may reduce the risk of subsequent neurocognitive impairment. CLINICALTRIALS.GOV:: NCT00855413.